S32 Zonulin Concentration in Patients With Inflammatory Bowel Diseases With and Without COVID-19 Infection

Abstract

Background: Previous research has shown smoking to have a deleterious effect on Crohn's Disease (CD) development, with smoking being identified as both a risk factor for CD and associated with poorer outcomes. Previous studies have shown smoking cessation interventions are associated with decreased rates of CD flares and lower rates of disease progression. While previous guidelines have called for increased focus on counseling for smoking cessation amongst CD patients, little research to date has demonstrated to what extent this counseling is routinely provided in an outpatient setting. Methods: We examined the rates of education for tobacco cessation among current and former smokers during visits for CD captured within the National Ambulatory Medical Care Survey (2002-2018) (NAMCS) and The National Hospital Ambulatory Medical Care Survey (2002-2011) (NHAMCS) database, a nationally representative dataset of outpatient visits. Patients with CD were identified using the International Classification of Diseases (ICD)-9-Clinical Modification codes 555.x as well as ICD-10-Clinical Modification codes K50. We analyzed rates of tobacco cessation counseling among all CD visits as well as CD visits for current/former tobacco users. In addition, a multivariable logistic regression model was performed to determine factors associated with rates of tobacco cessation counseling, including age, race, gender, geographic area and insurance type.Results: Among all visits for CD, the overall rate of counseling for tobacco cessation was 2.0% (95% CI: 1.1-3.5). The rate of counseling amongst former or current smokers with CD was slightly higher at 5.4% (95% CI: 2.9-10.0). In addition, rates of smoking cessation counseling were not significantly different between smokers with and without CD (P 5 0.26). In a multivariable logistic regression model, tobacco cessation counseling was less likely at visits with Hispanic patients compared to White, non-Hispanic patients with an aOR (adjusted odds ratio) of 0.06 (95% CI 0.01-0.30). Conclusion(s): Overall, rates of counseling and education for smoking cessation in outpatient CD visits were infrequent. Furthermore, lower rates of smoking cessation were noted in Hispanic patients compared to non-Hispanic patients, a finding documented in several previous studies. Though smoking has an important role in disease course and development, these findings indicate that education on smoking cessation does not frequently occur in the outpatient setting for CD patients. Overall, this highlights the need for increased focus by providers on screening and counseling for tobacco cessation in CD patients.

Modern concept of differential diagnosis of colitis: from G.F. Lang to the present day. A review

“…Для неинвазивной оценки проницаемости кишечной стенки используется фекальный зонулинбелок, обратимо повышающий проницаемость кишечной стенки путем изменения структуры плотных контактов боковых поверхностей эпителиальных клеток кишечника. По нашим данным, проницаемость кишечной стенки у пациентов с ВЗК и перенесенной новой коронавирусной инфекцией достоверно выше, чем у пациентов с ВЗК без новой коронавирусной инфекции в анамнезе [34,35].…”